1/47. Why is depression comorbid with chronic myofascial face pain? A family study test of alternative hypotheses.A number of explanations have been proposed to account for findings that rates of depression are elevated in persons with chronic, non-malignant pain disorders (CNPDs); for example, that CNPDs are variants of depression (e.g. 'masked depression'), that the stress of living with CNPDs contribute to the onset of depression ('diathesis-stress'), or that the correlation of CNPDs and depression is a methodological artifact of studying treatment-seeking samples. These alternative hypotheses are tested for one specific CNPD, chronic myofascial face pain, using a family study methodology. The procedure was to conduct direct psychiatric interviews with 106 patients with a history of carefully diagnosed myofascial face pain, 118 acquaintance controls without personal histories of myofascial face pain, and a random sample of adult first degree relatives of these case and control probands. The probands were further subdivided into four roughly equal samples consisting of cases with and without personal histories of major depressive disorder (MDD), and controls with and without personal histories of MDD. Dates of initial onsets of myofascial face pain and MDD in patient probands were obtained from interviews and records. The main results were that, compared to control probands without personal histories of MDD, MDD and depressive spectrum disorders (DSD) were elevated in the first degree relatives of control probands with personal histories of early onset MDD, but not in the first degree relatives of myofascial face pain probands with or without personal histories of early or late onset MDD. This outcome is consistent with the hypothesis that living with chronic myofascial face pain contributes to elevated rates of depression. It is inconsistent with the alternative hypotheses that this CNPD is a variant of depression or that the elevated MDD rates are simply an artifact of selection into treatment. The implications of these results and additional results consistent with them are discussed.- - - - - - - - - - ranking = 1keywords = relation, record (Clic here for more details about this article) |
2/47. Maxillofacial osteonecrosis in a patient with multiple "idiopathic" facial pains.Previous investigations have identified focal areas of alveolar bone tenderness, increased mucosal temperature, abnormal anesthetic response, radiographic abnormality, increased radioisotope uptake on bone scans, and abnormal marrow within the quadrant of pain in patients with chronic, idiopathic facial pain. The present case reports a 53-year-old man with multiple debilitating, "idiopathic" chronic facial pains, including trigeminal neuralgia and atypical facial neuralgia. At necropsy he was found to have numerous separate and distinct areas of ischemic osteonecrosis on the side affected by the pains, one immediately beneath the major trigger point for the lancinating pain of the trigeminal neuralgia. This disease, called NICO (neuralgia-inducing cavitational osteonecrosis) when the jaws are involved, is a variation of the osteonecrosis that occurs in other bones, especially the femur. The underlying problem is vascular insufficiency, with intramedullary hypertension and multiple intraosseous infarctions occurring over time. The present case report illustrates the extreme difficulties involved in the diagnosis and treatment of this disease.- - - - - - - - - - ranking = 18.673495999863keywords = jaw (Clic here for more details about this article) |
3/47. An unusual cause of unilateral facial pain.Cardiac pain that is referred to the face is a common symptom in patients with angina pectoris, but unilateral facial pain referred from a non-ischaemic cardiac source is rare. We report a case of unilateral facial pain that occurred in relation to a large pericardial effusion and which resolved on drainage of the effusion.- - - - - - - - - - ranking = 0.67619989849973keywords = relation (Clic here for more details about this article) |
4/47. cluster headache and cocaine use.We present 3 patients who had episodes of orofacial pain compatible with cluster headache, the differential diagnosis being established with pulp pain of dental origin. cocaine inhalation triggered pain in the premolar zone of the upper jaw, followed by spread of pain to the periorbital region on the same side. The pain episodes were very intense and lasted between 30 and 120 minutes. The patients presented conjunctival injection and lacrimation of the affected eye during these episodes. The crises were always unilateral. In one patient, pain shifted sides from one crisis to another within the same symptomatic or cluster period, affecting the side through which the drug was inhaled. Pain usually appeared 1 to 2 hours after cocaine consumption, though it disappeared 5 to 10 minutes after again inhaling the drug. None of our patients acknowledged cocaine consumption at the first visit; drug inhalation was only admitted at subsequent visits, once a degree of confidence had been established with the physician.- - - - - - - - - - ranking = 18.673495999863keywords = jaw (Clic here for more details about this article) |
5/47. An adult case of TMJ osteoarthrosis treated with splint therapy and the subsequent orthodontic occlusal reconstruction: adaptive change of the condyle during the treatment.This article reports treatment for a 21-year 11-month old female patient with severe osteoarthrosis of the TMJ with a special reference to adaptive changes of the condyle during the treatment. She had severe open bite with a Class II molar relationship; she had limited mouth opening, TMJ sounds, pain, and tinnitus. Lateral tomograms showed flattening and deep erosion on the left condyle, and an MRI revealed anterior disk displacement without reduction. By manipulation and splint therapy, TMJ pain and tinnitus were eliminated, then orthodontic treatment was initiated, maintaining the splint-induced position of the condyles. After 2 years of orthodontic treatment with a multibracket appliance, an acceptable occlusion was achieved with a Class I molar relationship. On lateral tomograms after treatment, bony deformation of the left condyle disappeared and adaptive remodeling was recognized with a uniform joint space in the left TMJ. However, repositioning of the disk was not achieved. Adaptive changes or functional remodeling experienced in this patient may be due to stable occlusion, uniform joint space, and the consequent biomechanical equilibrium in the TMJ.- - - - - - - - - - ranking = 2.4840137082381keywords = bite, relation (Clic here for more details about this article) |
6/47. Painful chewing and blindness: signs and symptoms of temporal arteritis.BACKGROUND: This case report illustrates the need to consider temporal arteritis in the differential diagnosis of jaw or tooth pain. This disease affects the cranial arteries, more frequently in women and usually in those older than age 60 years, causing jaw pain, visual symptoms, headache, scalp pain and sometimes blindness. CASE DESCRIPTION: A 71-year-old man had jaw pain that increased with chewing and speaking, scalp tenderness and dimming vision. A temporal artery biopsy confirmed the diagnosis of temporal arteritis. Treatment with decreasing amounts of oral steroids over 23 months was successful in relieving his signs and symptoms and in saving his vision. CLINICAL IMPLICATIONS: patients with this disease may seek care from their dentist first. jaw or tooth pain is the most reliable clinical symptom in the diagnosis of temporal arteritis. diagnosis and timely referral for treatment with oral steroids can prevent blindness.- - - - - - - - - - ranking = 56.020487999589keywords = jaw (Clic here for more details about this article) |
7/47. Periodontal and alveolar bone abnormalities associated with pachydermoperiostosis.Pachydermoperiostosis (PDP) is an unusual syndrome manifested clinically by finger clubbing, extremity enlargement, hypertrophic skin changes, and periosteal bone formation. A rare case of pachydermoperiostosis (primary hypertrophic osteoarthropathy) with oral manifestations in a 47-year-old man is presented. The possible correlation between physiological mechanisms of this disease and their influence on oral periodontal tissues and alveolar bone is discussed.- - - - - - - - - - ranking = 0.67619989849973keywords = relation (Clic here for more details about this article) |
8/47. Dracula's teeth syndrome.OBJECTIVE: To describe a patient with facial pain, ipsilateral facial dystonia, and phantom supernumerary teeth, beginning after resection of hypertrophic gums. She had familial sensorineural deafness. BACKGROUND: Atypical cranial dystonia subsequent to dental procedures is associated with facial pain, dysesthesias, or phantom phenomena, but not with phantom supernumerary teeth. patients with migraine are susceptible to experience cephalic phantom phenomena after dental procedures. Wynne syndrome is a hereditary autosomal dominant disorder characterized by congenital sensorineural deafness and supernumerary teeth. methods: Clinical examination, computerized tomography of paranasal sinuses and facial bones, magnetic resonance imaging of the brain, cranial electrophysiological testing, and electroencephalogram. RESULTS: A 52-year-old woman with history of migraine without aura for 40 years exhibited focal right facial involuntary tonic contracture accompanying chronic severe pain over the same area after gum resection. She reported a daily sensation of having two extra upper canine teeth pressing on her tongue, simulating vampire's ("Dracula's") teeth. She had high-frequency bilateral sensorineural deafness. Her computerized tomography studies, brain magnetic resonance imaging, and cranial electrophysiological testing were normal. CONCLUSION: This patient with chronic migraine had atypical cranial dystonia beginning after a dental procedure. Her dystonia was complicated by the unusual phenomenon of phantom supernumerary teeth. This condition may be misdiagnosed as atypical or psychogenic facial pain when facial dystonia is localized or subtle and is, therefore, confused with an idiosyncratic gesture or habitual spasm. Her signs and symptoms are reminiscent of Wynne syndrome.- - - - - - - - - - ranking = 1.1316139112386keywords = bite (Clic here for more details about this article) |
9/47. Enigmatic pain referred to the teeth and jaws.A number of obscure syndromes can mimic dental or jaw pain in the absence of pathosis within these structures. This enigmatic dental pain includes conditions such as pretrigeminal neuralgia, complex regional pain syndrome, temporal tendinitis, and carotodynia. Each of these syndromes is described through a pertinent case report to illustrate appropriate diagnosis and treatment.- - - - - - - - - - ranking = 93.367479999316keywords = jaw (Clic here for more details about this article) |
10/47. Orofacial pain of cardiac origin: a case report.It is the responsibility of the dentist to make the differential diagnosis of pain in the region of the oral cavity. Cardiac pain most commonly radiates to the left arm, shoulder, neck and face. In rare instances the pain may present as dental pain. In this case report, the patient presented with complaints of intense bilateral pain in the jaws which was diagnosed as pain of cardiac origin.- - - - - - - - - - ranking = 18.673495999863keywords = jaw (Clic here for more details about this article) |
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